808 resultados para Clinical problem-solving


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The issue of how to respond to the diverse academic needs of students is one of the central challenges of teaching. This project studied how preservice teachers develop an awareness of the needs of academically diverse learners and how they intend to implement and/or modify instruction to meet those needs. Participants all came from one university. As part of the design of the study, the participants were surveyed to investigate (a) their attitudes and beliefs towards academically diverse learners; (b) the teaching practices they would utilize in response to academic diversity in their classrooms; and (c) the confidence they have in their abilities to identify and address these various needs in their classrooms. Several strategies including activities to enhance creativity, cooperative learning, individual instruction, problem-solving activities, and projects were considered noteworthy for the ratings by the preservice teachers as appropriate for all students. Small differences were found based on the preservice teachers' year of placement in the School of Education, indicating that as students progress through this program, they may learn more about different techniques and when and for whom they are appropriate; however, differences across groups were not statistically significant. Results also indicated that across the different years in the program, preservice teachers did not have very high or very low confidence in addressing these issues in their own classrooms. Each grouping fell around the middle level of confidence.

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Mild Cognitive Impairment- Amnestic Subtype (MCIa) is a putative prodromal stage of Alzheimer’s Disease (AD) characterized by focal deficits in episodic verbal memory. Less is known about relative deficits in visuospatial learning, although there is ample evidence indicating involvement of the hippocampus in visuospatial learning, as well as hippocampal degeneration in early AD. The aim of this study was to better characterize the components of working memory dysfunction in people with MCIa to increase the ability to reliably diagnose this disease. Fifty-six elderly adults diagnosed with MCIa and 94 healthy elderly completed a hidden maze learning task. Results indicated similar functioning between groups on measures of reasoning, problem solving, and accuracy. However, MCIa subjects were less efficient at learning the hidden path, making more errors per second on average (Cohen’s d= -.78) and requiring a longer time to complete the maze (Cohen’s d=.77). The learning curve between the first two trials was four times as steep for healthy elderly compared to MCIa (slopes = 4.9 vs. 1.24, respectively), indicating that MCIa subjects exhibited relative difficulty in holding and making effective use of an internal spatial map in order to improve performance. Our results suggest that MCIa patients have focal deficits in visuospatial working memory, with relative preservation of functioning on other more global measures of cognitive functioning. This particular pattern of results may be specific to the amnestic variant of MCI.

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The SureMath scheme is an alternate algebraic approach to "word problem" solving. It is used here in a freshman chemistry setting to aid students who need another method for solving chemistry problems.

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Neuropathic pain is a debilitating neurological disorder that may appear after peripheral nerve trauma and is characterized by persistent, intractable pain. The well-studied phenomenon of long-term hyperexcitability (LTH), in which sensory somata become hyperexcitable following peripheral nerve injury may be important for both chronic pain and long-lasting memory formation, since similar cellular alterations take place after both injury and learning. Though axons have previously been considered simple conducting cables, spontaneous afferent signals develop from some neuromas that form at severed nerve tips, indicating intrinsic changes in sensory axonal excitability may contribute to this intractable pain. Here we show that nerve transection, exposure to serotonin, and transient depolarization induce long-lasting sensory axonal hyperexcitability that is localized to the treated nerve segment and requires local translation of new proteins. Long-lasting functional plasticity may be a general property of axons, since both injured and transiently depolarized motor axons display LTH as well. Axonal hyperexcitability may represent an adaptive mechanism to overcome conduction failure after peripheral injury, but also displays key features shared with cellular analogues of memory including: site-specific changes in neuronal function, dependence on transient, focal depolarization for induction, and requirement for synthesis of new proteins for expression of long-lasting effects. The finding of axonal hyperexcitability after nerve injury sheds new light on the clinical problem of chronic neuropathic pain, and provides more support for the hypothesis that mechanisms of long-term memory storage evolved from primitive adaptive responses to injury. ^

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Colorectal cancer (CRC) has become a public health concern due to the underutilization of the various screening methods. There is a need to understand a patient's decision making process in regards to their health and obtaining the appropriate screening. Previous research has defined patient autonomy in two dimensions: The patient's involvement in the decision making process and their desire to be informed (Ende, Kazis, Ash, & Moskowitz, 1989). Past research shows that patients have a high desire to be informed, but a low desire to be involved in the medical decision process. Deber, Kraetschmer, and Irvine (1996) developed a measure which consisted of two subscales that measures patients' involvement: Patient's desire to be involved in the problem solving (PS) and decision making (DM) process. Little research has examined the desire for involvement and decision making of Latino populations. The present study sought to investigate the psychometric properties of the Deber et al. (1996) measure. In general, Latino patients in the present sample had low desire for autonomy in health decisions or to be involved in the decision making processes of their health related issues. ^

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Suicide is recognized as a major public health and clinical problem in the United States. One fifth of adolescents in the United States seriously consider suicide each year, and about 8% of high school students attempt suicide at least once. Hispanic ethnicity constitutes a risk factor for suicidal ideation and suicide attempts, with Hispanic females at highest risk. Nevertheless, published studies on suicidal behavior in Hispanic female adolescents are extremely limited and focus on suicidal ideation in school samples. Given the severity of the problem and the paucity of information on this topic, more research on ethnic differences in suicidal ideation in community samples of high-risk children is urgently needed. This cross-sectional study delineated differences in suicide ideation between Hispanic female adolescents and non-Hispanic white female adolescents attending a mental health clinic and examined the association of ethnicity with suicide ideation independent of other known risk factors. Data were accrued between June 2004 and December 2008 in a Harris County Mental Health and Mental Retardation Association (MHMRA) clinic. Data were limited to adolescents who were Harris County Residents between the ages of 10 to 17 years when they were admitted to the clinic. The objective of this study was to determine whether differences in socio-demographic and clinical variables play a significant role in ethnic disparities in suicide ideation. A series of logistic regressions were performed to estimate the association between ethnicity and suicide ideation after controlling for potentially confounding factors. ^ Results showed an interaction between Hispanic ethnicity and having a history of treatment: Hispanic girls having history of treatment had lower odds of having suicide ideation than Hispanic girls without such a history. After adjusting for treatment history, family problems, substance use, juvenile justice involvement, current treatment, and age, Hispanic girls had 1.86 times the odds of having suicide ideation than non Hispanic girls (OR=1.86, 95% CI=0.88-1.46). Although additional studies on community samples of high risk adolescents are needed to verify these findings, our study highlights the fact that Hispanic girls are at significantly higher risk and need to be targeted for prevention and treatment efforts. ^

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This investigation focused on how people cope with the demands of their environment in a competent manner. It sought to assess the effects of learning competent coping behaviors on self-reported well-being. The study chose a community-evolved, organized effort on the part of a group of neighborhoods to build competence in the Mexican-American community of East Los Angeles. This network was a citizen-action organization called the United Neighborhoods Organization. UNO was selected because it concentrated on developing community leaders by using spiritual beliefs and family values as shared community resources. Neighborhood leaders were encouraged to engage in risk-taking and confrontation maneuvers. They were also taught problem-solving skills and provided with social support.^ A survey instrument was developed to assess sociodemographic characteristics, acculturation history and status, willingness to engage in risk-taking and confrontation and self-perceived general well-being. The study relied on eight months of daily participant-observation of the organization, the East Los Angeles environment and the interaction between the two. At the end of the observation period, a sample of 150 UNO participants were given the survey questionnaire as was a matched group of 150 non-UNO participants who were ELA residents.^ The study sample was mostly women, in their middle age years who had lived in the area from 5 to more than 30 years. Significantly more single persons were found in the UNO group. The sample was almost equally divided into English and Spanish speaking respondents. Acculturatively almost all the sample fell in the Very Mexican and Mostly Mexican types. The survey found a trend of association between participating in UNO and reporting feeling well. A statistically significant association was found among UNO participants between taking risks and reporting feeling well, regardless of a tendency for all the sample to minimize risk. A trend was seen for married UNO participants to report feeling well. Slightly more UNO participants were willing to engage in confrontation and a substantial proportion of the participants who were confronters reported feeling well in comparison to their counterparts. Ethnic pride was positively associated with participation in UNO and showed a trend in the expected direction with reported self-perceived well-being. ^

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The purpose of the study was to describe regionalized systems of perinatal care serving predominantly low income Mexican-American women in rural underserved areas of Texas. The study focused upon ambulatory care; however, it provided a vehicle for examination of the health care system. The questions posed at the onset of the study included: (1) How well do regional organizations with various patterns of staffing and funding levels perform basic functions essential to ambulatory perinatal care? (2) Is there a relationship between the type of organization, its performance, and pregnancy outcome? (3) Are there specific recommendations which might improve an organization's future performance?^ A number of factors--including maldistribution of resources and providers, economic barriers, inadequate means of transportation, and physician resistance to transfer of patients between levels of care--have impeded the development of regionalized systems of perinatal health care, particularly in rural areas. However, studies have consistently emphasized the role of prenatal care in the early detection of risk and treatment of complications of pregnancy and childbirth, with subsequent improvement in pregnancy outcomes.^ This study has examined the "system" of perinatal care in rural areas, utilizing three basic regional models--preventive care, limited primary care, and fully primary care. Information documented in patient clinical records was utilized to compare the quality of ambulatory care provided in the three regional models.^ The study population included 390 women who received prenatal care in one of the seven study clinics. They were predominantly hispanic, married, of low income, with a high proportion of teenagers and women over 35. Twenty-eight percent of the women qualified as migrants.^ The major findings of the study are listed below: (1) Almost half of the women initiated care in the first trimester. (2) Three-fourths of the women had or exceeded the recommended number of prenatal visits. (3) There was a low rate of clinical problem recognition. Additional follow-up is needed to determine the reasons. (4) Cases with a tracer condition had significantly more visits with monitoring of the clinical condition. (5) Almost 90% of all referrals were completed. (6) Only 60% of mothers had postpartum follow-up, while almost 90% of their newborns received care. (7) The incidence of infants weighing 2500 grams or less was 4.2%. ^

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InGen of Creative Production in the Health Sciences is a compendium of innovative thinking exercises for individuals and groups, derived from an eclectic array of practical guides for professionals in a variety of fields. Segmented into five subcategories across twenty two chapters, the effort seeks to make techniques for increasing innovative problem solving more accessible to a diverse audience of problem solvers. The chapters of Roberta Ness. Innovation Generation (2012, Oxford University Press) provide the themes for each of the chapters in the workbook. It is intended that those who read Ness. Innovation Generation will benefit from practicing the constructs of innovative thinking exemplified in each exercise.^ The methods used to gather data, in this case mostly innovative thinking exercises, included literature reviews of existing innovative thinking tools, classroom materials, and theory-driven exploration of exercises to fill in gaps in extant materials. Specifically, Google.com and Amazon.com searches were conducted using the terms “innovation,” “innovative,” “innovator,” “creative,” “novelty,” “thinking,” together with some variance of “book,” “workbook,” and “exercise.” The results were sorted thematically to show correspondence with the themes in Ness (2012) and compared to suggested best practices of 50 years of scientific research on innovative thinking. Where themes were suggested by Ness (2012) and peer-reviewed research on innovation but unavailable in published innovation thinking workbooks, new exercises were developed. The five type subcategories into which these results were organized are: individual direct, individual indirect, group direct, group indirect and probing question. It is anticipated that the five type subcategories and spectrum of themes will equip problem solvers in a variety of capacities.^

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Adolescent substance use is a serious public health concern with long-lasting consequences. Although specific coping behaviors have been associated with adolescent substance use, less is known about the role of multidimensional coping styles that account for both positive and negative coping behaviors. This study examined the association of coping styles and substance use (alcohol, marijuana, and other illicit drugs) of 1,019 ethnically diverse high school students. Coping styles were categorized by high or low negative coping behaviors (e.g. distraction, social withdrawal, self-criticism, blame others, wishful thinking, resignation, and negative emotional regulation) and high or low positive coping behaviors (e.g. cognitive restructuring, problem-solving, social support, and positive emotional regulation). My hypothesis that high positive coping, regardless of the use of negative coping behaviors, would be protective against substance use was rejected. Logistic regression analyses controlling for age, gender, race, and parent education indicated that adolescents who relied primarily on adaptive coping were 45-67% less likely to report lifetime or past year substance use than any other coping style. However, mixed copers (i.e. high in both positive and negative coping behaviors) were 2 to 3 times as likely to report substance use than their adaptive coping counterparts.^

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El presente trabajo es producto de la tesis doctoral titulada La generación de mundos de ficción en jóvenes sordos. La literatura como herramienta para el desarrollo del pensamiento creativo y del Proyecto de investigación: Estrategias pedagógico-didácticas para el desarrollo y aprendizaje de las habilidades sociales en escuelas públicas de enseñanza común y especial del gran Mendoza, dirigido por el Dr. Benito Parés.2 En dicho trabajo se pone en evidencia cómo a través de espacios de literatura se desarrollan las habilidades sociales de autoafirmación, entre otras, tal como la autoestima y la confianza en uno mismo a partir de la utilización de técnicas de creatividad literaria. En esta investigación nos interesó indagar respecto de las posibilidades de los jóvenes sordos para generar textos de ficción que permitieran desarrollar el pensamiento divergente, y pudimos advertir también, las habilidades sociales que se ponen en juego ante las tareas solicitadas a dichos jóvenes. A partir de las propuestas de trabajo realizadas por las Personas Sordas que participaron del proyecto, observamos por un lado el cambio de actitud frente a la tarea y por otro las manifestaciones de placer al realizar las actividades propuestas. En relación con los resultados, pudimos apreciar la presencia de habilidades sociales de autoafirmación, resolución de problemas, comunicacionales, de expresión de emociones y sentimientos entre otras, como consecuencia del trabajo con textos literarios.

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Se plantea la discusión sobre la cientificidad de la Archivística desde la perspectiva kuhniana. Se realiza una reseña histórica de la disciplina, mencionando sus principales logros teóricos. Se analizan diversos intentos propuestos por autores para dotar de fundamentos epistemológicos al área. Las posturas estudiadas para este análisis son aquellas que proponen un enfoque desde la perspectiva de Thomas Kuhn. Se observa en la literatura el uso del concepto paradigma como modelo de análisis para el fundamento epistemológico de la disciplina. Se analizan las problemáticas surgidas a partir su introducción, notando que con su aplicación se incurre en una mudanza de niveles de análisis epistémicos. Como consecuencia, resulta dificultoso esclarecer las pretensiones de cientificidad de la Archivística. Se presenta como primera interrogante la posibilidad de articular el desarrollo histórico de la Archivística con la existencia de paradigmas; y en segundo término se plantea si los paradigmas identificados en la literatura pueden ser considerados como tales, o si se trata de teorías que han adquirido cierto grado de organización. Se afirma que la cientificidad y madurez disciplinar se determina mediante la asunción de una tradición exitosa de resolución de problemas, ya que los intentos exitosos terminan consolidando el campo de investigación.

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Se plantea la discusión sobre la cientificidad de la Archivística desde la perspectiva kuhniana. Se realiza una reseña histórica de la disciplina, mencionando sus principales logros teóricos. Se analizan diversos intentos propuestos por autores para dotar de fundamentos epistemológicos al área. Las posturas estudiadas para este análisis son aquellas que proponen un enfoque desde la perspectiva de Thomas Kuhn. Se observa en la literatura el uso del concepto paradigma como modelo de análisis para el fundamento epistemológico de la disciplina. Se analizan las problemáticas surgidas a partir su introducción, notando que con su aplicación se incurre en una mudanza de niveles de análisis epistémicos. Como consecuencia, resulta dificultoso esclarecer las pretensiones de cientificidad de la Archivística. Se presenta como primera interrogante la posibilidad de articular el desarrollo histórico de la Archivística con la existencia de paradigmas; y en segundo término se plantea si los paradigmas identificados en la literatura pueden ser considerados como tales, o si se trata de teorías que han adquirido cierto grado de organización. Se afirma que la cientificidad y madurez disciplinar se determina mediante la asunción de una tradición exitosa de resolución de problemas, ya que los intentos exitosos terminan consolidando el campo de investigación.

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Se plantea la discusión sobre la cientificidad de la Archivística desde la perspectiva kuhniana. Se realiza una reseña histórica de la disciplina, mencionando sus principales logros teóricos. Se analizan diversos intentos propuestos por autores para dotar de fundamentos epistemológicos al área. Las posturas estudiadas para este análisis son aquellas que proponen un enfoque desde la perspectiva de Thomas Kuhn. Se observa en la literatura el uso del concepto paradigma como modelo de análisis para el fundamento epistemológico de la disciplina. Se analizan las problemáticas surgidas a partir su introducción, notando que con su aplicación se incurre en una mudanza de niveles de análisis epistémicos. Como consecuencia, resulta dificultoso esclarecer las pretensiones de cientificidad de la Archivística. Se presenta como primera interrogante la posibilidad de articular el desarrollo histórico de la Archivística con la existencia de paradigmas; y en segundo término se plantea si los paradigmas identificados en la literatura pueden ser considerados como tales, o si se trata de teorías que han adquirido cierto grado de organización. Se afirma que la cientificidad y madurez disciplinar se determina mediante la asunción de una tradición exitosa de resolución de problemas, ya que los intentos exitosos terminan consolidando el campo de investigación.

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Se plantea la discusión sobre la cientificidad de la Archivística desde la perspectiva kuhniana. Se realiza una reseña histórica de la disciplina, mencionando sus principales logros teóricos. Se analizan diversos intentos propuestos por autores para dotar de fundamentos epistemológicos al área. Las posturas estudiadas para este análisis son aquellas que proponen un enfoque desde la perspectiva de Thomas Kuhn. Se observa en la literatura el uso del concepto paradigma como modelo de análisis para el fundamento epistemológico de la disciplina. Se analizan las problemáticas surgidas a partir su introducción, notando que con su aplicación se incurre en una mudanza de niveles de análisis epistémicos. Como consecuencia, resulta dificultoso esclarecer las pretensiones de cientificidad de la Archivística. Se presenta como primera interrogante la posibilidad de articular el desarrollo histórico de la Archivística con la existencia de paradigmas; y en segundo término se plantea si los paradigmas identificados en la literatura pueden ser considerados como tales, o si se trata de teorías que han adquirido cierto grado de organización. Se afirma que la cientificidad y madurez disciplinar se determina mediante la asunción de una tradición exitosa de resolución de problemas, ya que los intentos exitosos terminan consolidando el campo de investigación.